Róisín Shortall (Dublin North West, Social Democrats) | Oireachtas source

I note that we are having yet another health debate and the Minister for Health is not present. This has been the case for the past week when there have been a number of different health debates. It is really not acceptable that he is not here doing his job as Minister. We have had the breaking scandal of child and adolescent mental health services, CAMHS, in south Kerry and serious concerns about the standard of CAMHS services throughout the country. He is not around for any of that and nor is his Secretary General. Today, we are talking about the lifting of Covid restrictions, which is, again, a very important debate and he is not around for it. We had a debate last week on mental health services and we had a debate this morning on cancer services.

The idea of the Minister for Health being off in Dubai with the Secretary General for what will be more than a week is just not acceptable, especially given the nature of the event he is attending. I was gobsmacked to hear the justification the Taoiseach provided last week for that trip. This is a commercial expo. It seems it is an Enterprise Ireland expedition that includes a number of Irish start-up companies. The Taoiseach talked about leveraging capital, making important contacts and networking with the business community. That is nothing to do with public health. The Minister and the Secretary General are charged with providing a properly functioning public health service. We patently do not have that. There are serious problems and the Minister should be concentrating on those rather than on what appears to be feeding the kind of creeping privatisation that is going on and is doing so much damage to our public health service.

I am really disappointed that the Minister and his Secretary General have chosen to be away for a week at that event and that the Taoiseach chose to justify it on the grounds that these were business opportunities. We do not want business opportunities within our public health service, we want a properly functioning public health service that is accountable, answerable, adequately resourced and fully staffed. That is the Minister's primary responsibility and he is not living up to it.

Like most people, I welcome the easing of the Covid-19 restrictions. It is great to be at a point where we can start to live life fully and catch up on so many things that were missed out on over the past two years. Credit goes to everybody involved in that national effort at all levels to get us to this point. It is very much to be welcomed. However, I want to talk about a particular cohort of people who are not delighted that the restrictions have been lifted because it makes them even more vulnerable than they were previously. I refer to that cohort of people who are immunocompromised. We know that there are at least 109,000 people in this cohort, which is a significant number. I am not sure that adequate consideration or thought has been given to this cohort of people. I have received representations from Chronic Lymphocytic Leukaemia Ireland, CLLI, an advocacy group for people with blood cancer in particular. It has made a very strong case in writing to the Minister on these points. There is a lack of clarity.

At a meeting this morning of the Joint Committee on Health with representatives of NPHET, I asked a number of questions but the witnesses were not in a position to answer them. I will ask them again here. First, what is the position with regard to the fourth vaccination, which is the booster in the case of people who are immunocompromised? There has been a complete lack of information and advice in that regard. People have to wait three months after their third dose to get the fourth dose, but many people are at that stage now, having got their third dose in October. There is no information on that. These people want to know the arrangements for the roll-out of the booster, that is, the fourth dose and how people go about doing that. It came to light in recent days that there is a facility for booking an appointment but nobody has been told that. There is a need for clarity on that. These people have also expressed concern about the implications for them of going to vaccination centres. It is not the safest place to be if one is a vulnerable person with a serious underlying condition. Are other arrangements being made for them to receive their booster dose?

The second question is in regard to the issue of antivirals. For people who are medically vulnerable antivirals are essential. If they get the virus, it is really important that antivirals are provided to them as quickly as possible. There is a strict time limit of a matter of days involved. It is really important that there is clarity on what one should do if one is immunocompromised and one gets the virus. There is no direction on that. We know that orders have placed and that deliveries have been made of antivirals, but as of yet there is no plan for rolling them out. Time is of the essence in this regard. There should be clear protocols. There is a clear plan in, for example, the UK in regard to how a person in that situation should go about accessing antivirals.

The third issue is monoclonal antibody treatments. Regrettably, for some people who have serious underlying conditions the vaccination is not effective. It does not provide protection. It is really important that people can establish if they are one of those people so that they have access to antibody treatments. I ask the Ministers of State, Deputies Butler and Feighan, to pass on all of these issues to the Minister whenever he returns and please to provide clear information to the 109,000 people who feel very vulnerable at this stage.

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